JCPSP 2005, Vol. 15 (9): 547-551 547 INTRODUCTION Measles is an acute highly communicable viral illness. 1 Its incidence in childhood varies from 58% in epidemics to 10- 15% in endemic form. 2 Globally about 40 million cases of measles occur every year out of which 70% occur in Africa and South Asia. Every year 777,000 deaths occur due to measles, 11 countries, including Pakistan account for 66% of these deaths. 3 Case fatality rates in developing countries are usually estimated to be in the range 1-5%. 4 This represents 50-60% of the estimated million deaths attributable to vaccine preventable diseases of childhood. 3 It is due to the fact that measles causes immuno-suppression which leads to complications. 5 One out of 20 children with measles gets pneumonia 6 and 1 out of 1000 children gets encephalitis 1 , out of these 15% die and 25–35% are left with permanent neurologic sequelae. 1 Children are at increased risk of dying for a year after their measles due to impaired cellular immunity. 1 Death caused by sub acute sclerosing panencephalitis can occur about 12 years after measles. 5 The World Summit of Children has set a goal of 90% reduction of measles cases and 95% reduction of measles deaths compared to pre-vaccine era. 7 In many developing countries measles is the last vaccine to be given in the routine schedule; therefore, it has the lowest coverage. 8 Pakistan has single dose (at 9 months age) measles vaccination coverage of 57% from 2001 9 to 2002. 10 Other countries like Iran, Iraq, Palestine, Syria and United Arab Emirates have started second routine dose of measles at 15 months of age with a high coverage of 90% or more. 11 Data from developing countries have shown low seroconversion rate after single measles vaccination at an early age as compared to developed countries. 12 Still vaccinated measles cases have lower mortality rate. 8 Low vaccine coverage rate with low vaccine efficacy leads to higher rate of complications, some leading to hospitalization, which causes financial burden on the family as well as the government. 13 Therefore, children hospitalized with complications of measles can provide information regarding the scope of the problem, which can then help in developing preventive strategies. The aim of this study was to find the association of clinical outcome of measles with demographic profile and complications in patients hospitalized with complicated measles. PATIENTS AND METHODS This cross-sectional analytical study was conducted at the Children’s Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to August 2004. Six months to 12 years old children presenting with measles and ORIGINAL ARTICLE CLINICAL OUTCOME IN CHILDREN HOSPITALIZED WITH COMPLICATED MEASLES Brekhna Aurangzeb, Yasir Bin Nisar, Tabish Hazir, Fayyaz Burki and Mumtaz Hassan ABSTRACT Objective: To determine the association of clinical outcome of measles in children with demographic profile and complications. Design: A cross-sectional analytical study. Place and Duration of Study: Isolation ward, The Children’s Hospital, Pakistan Institute of Medical Sciences (PIMS), from January 2003 to August 2004. Patients and Methods: Detailed history and physical examination of all the hospitalized patients with complications of measles was filled in case report form. Immunization cards were assessed for measles vaccination status. Data was analyzed by using SPSS version 10 software. The clinical outcome of measles was compared with demographic profile and complications by using Chi-square test and p-values were obtained. Results: Two hundred and five hospitalized patients with complications of measles were studied. There were 61.5% males. Mean age was 46.1 months and 57% patients were vaccinated against measles. Malnourished patients were 71.2% and had a longer hospital stay (p=0.010). Pneumonia (40.0%) and diarrhoea (38.5%) were the commonest complications. Seven children died. Mortality was significantly associated with younger age (p=0.04), unvaccinated status (p=0.04) and presence of encephalitis (p=0.00001). Conclusion: The most common complications of measles are pneumonia and diarrhoea with dehydration requiring hospitalization. Malnourished children experience more complications and have longer hospital stay. Mortality is significantly associated with infancy, unvaccinated status and encephalitis. A second dose of measles should be introduced at 15 months of age. KEY WORDS: Measles. Complications. Mortality. Vaccination. Infancy. Unvaccinated status. Encephalitis. Isolation Ward, The Children’s Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Correspondence: Dr. Brekhna Aurangzeb, Isolation Ward, The Children’s Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad. E-mail: bshifa@yahoo.com & drbin01@hotmail.com Received September 27, 2004; accepted May 06, 2005.